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Other Hospitals Continue Limited Use
Hexachlorophene Ban Instituted at CMMC
By Margaret Martin
Times Medical Writer
Use of hexachlorophene for bathing
babies in the nursery at Confederate
Memorial Medical Center stopped yester-day,
but other area hospitals are still
using the solution in varying amounts.
Both the U.S. Food and Drug Adminis-tration
and the Committee on Fetus and
Newborn of the American Academy of
Pediatrics have recommended the aboli-tion
of use on infants of soap containing
the chemical.
In its place, "at present we recom-mend
dry skin care, washing with plain
soap and water or tap water alone for
skin care of the newborn infants. It
should be emphasized that the most
important factor in the transmission of
infection from infant to infant is hand
contact. This can be minimized by
scrupulous hand washing before entering
the nursery as well as just before and
just after handling each infant . . .,"
said a directive from the two groups.
The FDA has ordered drug companies
to adopt precautionary labeling for some
germicidal soaps and skin cleansers
containing 2 per cent to 3 per cent hex-achlorophene.
Hexachlorophene is a chemical which
is highly effective against bacteria, but
sometimes causes toxicity.
Blamed for Brain Lesions
Safety action of the FDA was based
on a study in which rhesus monkeys
scrubbed with one of the soaps contain-ing
the chemical daily for three months
were shown to have lesions in the brain,
according to the Dec. 24 issue of
"Medical World News."
Babies at the Confederate nursery had
not been bathed routinely with hexach-lorophene
soaps for over a year, said Dr.
Joseph Little, head of the Department of
Pediatrics at the Louisiana State Univer-sity
Medical School at Shreveport, and at
Confederate.
But the solution being used to bathe
newborns contained "less than one half
of 1 per cent of hexachlorophene," even
this was stopped Friday, he added.
Little and Dr. Juan J. Gershanik,
neonatologist with the medical school,
were questioned by The Times Thursday
about the use of the chemical. They
checked with the American Academy of
Pediatrics and said yesterday that use of
even the small amount would be stopped
and something else used after yesterday.
But, said Little, "We will continue to
have physicians, nurses and aides wash
their hands with it and continue to use it
in any procedure which requires sterili-zation
in pediatrics."
He said, "We have been aware for
over a year that when hexachlorophene
is ingested (swallowed) it is toxic," and
"when it is absorbed into the area of skin
over a burn it can produce toxicity."
"The reason for its restriction," Little
said "is the question of absorption of the
drug in contact with the skin. There is
now no known effect, if any, in small
babies who have been routinely bathed
with hexachlorophene-containing soap."
There is an unknown danger, he said
"as to whether the small amount of
absorption can lead to future toxic
reaction."
But, he said "we will follow the
recommendation of the FDA and discon-tinue
any routine bathing of babies with
soaps which contain hexachlorophene."
Dr. Pattie Van Hook, head of the
Caddo-Shreveport Health Unit, said publ-ic
health nurses do not ordinarily deal
with use of the soap in newborns.
She did say, though, that she would
agree with the statement issued by the
FDA, the American Academy of Pedia-trics
and Dr. Andrew Hedmeg, the state
health officer, who, in a directive said,
"the use of hexachlorophene for total
body bathing of infants in hospital
nurseries or at home is not recommend-ed."
The directive quoted the FDA and
the academy's stand on the matter.
Dr. Clarence Webb, a former presi-dent
of the academy, said he is head of a
committee at Schumpert Hospital which
is studying the situation and will make a
report next week.
"It has been used in all nurseries, all
over the country," he said referring to a
name brand soap containing the chemi-cal,
but he added, "I suspect that it will
not be used routinely on a day to day
basis, for a full body bath but only on
medical order from now on."
Jim Elrod, administrator at Willis-
Knighton Hospital, said "we have been
expecting for two or three months that
something major would hit on this."
He said the hospital's pediatrics
department will continue to use the soap
containing the chemical for a newborn's
initial bath, "but we will not send any
home with the mother."
"We feel," he added, "that the
advantages of using it for the initial bath
outweigh the disadvantages."
He said pediatricians at Willis-Knigh-ton
are working with the Schumpert
committee to see what to do in the long
run.
Bossier City General Hospital's nur-sery
discontinued using the soap on
babies as a precautionary measure Jan.
1, according to Richard Herrmann, head
of the hospital.
The matter also is being studied at
Doctors Hospital, according to Adminis-trator
Charles Boyd, who said "the
medicine has been pulled out of the
nursery,"
Literature Studied
"The literature was passed out at a
meeting of the obstetrics and gynecolo-gists."
said Paul Senft, administrator at
P&S Hospital, "but they've not done
anything about the nursery."
"I think we'll change use of it anyway
for the total hospital," he added.
"It is under consideration by the
medical staff committee now," he said.
Soaps containing hexachlorophene are
"used only on prescription of a pediatri-cian
to bathe newborns in the nursery,"
at the U.S. Air Force Hospital at
Barksdale Air Force Base, according to
Col. Clayton H. Schmidt, commander at
the facility.
And at Highland Hospital, Administra-tor
Joe Allen said, "We are still using
some items containing hexachlorophene."
"It is no big deal. We have rnver used
a great deal — we used it as prescribed
by pediatricians," he added.
Referring to the medical research
which has shown harmful effects of
hexachlorophene when used on animals,
Allen added, "We don't wash rats with
it."

Physical rights are retained by Louisiana State University Health Sciences Center Shreveport. Copyright is retained in accordance with U.S. copyright laws.

Text

Other Hospitals Continue Limited Use
Hexachlorophene Ban Instituted at CMMC
By Margaret Martin
Times Medical Writer
Use of hexachlorophene for bathing
babies in the nursery at Confederate
Memorial Medical Center stopped yester-day,
but other area hospitals are still
using the solution in varying amounts.
Both the U.S. Food and Drug Adminis-tration
and the Committee on Fetus and
Newborn of the American Academy of
Pediatrics have recommended the aboli-tion
of use on infants of soap containing
the chemical.
In its place, "at present we recom-mend
dry skin care, washing with plain
soap and water or tap water alone for
skin care of the newborn infants. It
should be emphasized that the most
important factor in the transmission of
infection from infant to infant is hand
contact. This can be minimized by
scrupulous hand washing before entering
the nursery as well as just before and
just after handling each infant . . .,"
said a directive from the two groups.
The FDA has ordered drug companies
to adopt precautionary labeling for some
germicidal soaps and skin cleansers
containing 2 per cent to 3 per cent hex-achlorophene.
Hexachlorophene is a chemical which
is highly effective against bacteria, but
sometimes causes toxicity.
Blamed for Brain Lesions
Safety action of the FDA was based
on a study in which rhesus monkeys
scrubbed with one of the soaps contain-ing
the chemical daily for three months
were shown to have lesions in the brain,
according to the Dec. 24 issue of
"Medical World News."
Babies at the Confederate nursery had
not been bathed routinely with hexach-lorophene
soaps for over a year, said Dr.
Joseph Little, head of the Department of
Pediatrics at the Louisiana State Univer-sity
Medical School at Shreveport, and at
Confederate.
But the solution being used to bathe
newborns contained "less than one half
of 1 per cent of hexachlorophene," even
this was stopped Friday, he added.
Little and Dr. Juan J. Gershanik,
neonatologist with the medical school,
were questioned by The Times Thursday
about the use of the chemical. They
checked with the American Academy of
Pediatrics and said yesterday that use of
even the small amount would be stopped
and something else used after yesterday.
But, said Little, "We will continue to
have physicians, nurses and aides wash
their hands with it and continue to use it
in any procedure which requires sterili-zation
in pediatrics."
He said, "We have been aware for
over a year that when hexachlorophene
is ingested (swallowed) it is toxic," and
"when it is absorbed into the area of skin
over a burn it can produce toxicity."
"The reason for its restriction," Little
said "is the question of absorption of the
drug in contact with the skin. There is
now no known effect, if any, in small
babies who have been routinely bathed
with hexachlorophene-containing soap."
There is an unknown danger, he said
"as to whether the small amount of
absorption can lead to future toxic
reaction."
But, he said "we will follow the
recommendation of the FDA and discon-tinue
any routine bathing of babies with
soaps which contain hexachlorophene."
Dr. Pattie Van Hook, head of the
Caddo-Shreveport Health Unit, said publ-ic
health nurses do not ordinarily deal
with use of the soap in newborns.
She did say, though, that she would
agree with the statement issued by the
FDA, the American Academy of Pedia-trics
and Dr. Andrew Hedmeg, the state
health officer, who, in a directive said,
"the use of hexachlorophene for total
body bathing of infants in hospital
nurseries or at home is not recommend-ed."
The directive quoted the FDA and
the academy's stand on the matter.
Dr. Clarence Webb, a former presi-dent
of the academy, said he is head of a
committee at Schumpert Hospital which
is studying the situation and will make a
report next week.
"It has been used in all nurseries, all
over the country," he said referring to a
name brand soap containing the chemi-cal,
but he added, "I suspect that it will
not be used routinely on a day to day
basis, for a full body bath but only on
medical order from now on."
Jim Elrod, administrator at Willis-
Knighton Hospital, said "we have been
expecting for two or three months that
something major would hit on this."
He said the hospital's pediatrics
department will continue to use the soap
containing the chemical for a newborn's
initial bath, "but we will not send any
home with the mother."
"We feel," he added, "that the
advantages of using it for the initial bath
outweigh the disadvantages."
He said pediatricians at Willis-Knigh-ton
are working with the Schumpert
committee to see what to do in the long
run.
Bossier City General Hospital's nur-sery
discontinued using the soap on
babies as a precautionary measure Jan.
1, according to Richard Herrmann, head
of the hospital.
The matter also is being studied at
Doctors Hospital, according to Adminis-trator
Charles Boyd, who said "the
medicine has been pulled out of the
nursery,"
Literature Studied
"The literature was passed out at a
meeting of the obstetrics and gynecolo-gists."
said Paul Senft, administrator at
P&S Hospital, "but they've not done
anything about the nursery."
"I think we'll change use of it anyway
for the total hospital," he added.
"It is under consideration by the
medical staff committee now," he said.
Soaps containing hexachlorophene are
"used only on prescription of a pediatri-cian
to bathe newborns in the nursery,"
at the U.S. Air Force Hospital at
Barksdale Air Force Base, according to
Col. Clayton H. Schmidt, commander at
the facility.
And at Highland Hospital, Administra-tor
Joe Allen said, "We are still using
some items containing hexachlorophene."
"It is no big deal. We have rnver used
a great deal — we used it as prescribed
by pediatricians," he added.
Referring to the medical research
which has shown harmful effects of
hexachlorophene when used on animals,
Allen added, "We don't wash rats with
it."